Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.242
Filtrar
1.
BMC Infect Dis ; 20(1): 295, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316920

RESUMO

BACKGROUND: Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging. CASE PRESENTATION: We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM. CONCLUSIONS: Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.


Assuntos
Face/microbiologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Micobactérias não Tuberculosas/isolamento & purificação , Adolescente , Criança , DNA Viral/metabolismo , Feminino , Fungos/isolamento & purificação , Humanos , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium fortuitum/genética , Mycobacterium fortuitum/isolamento & purificação , Micobactérias não Tuberculosas/genética , Microbiologia da Água , Adulto Jovem
2.
Int J Infect Dis ; 92S: S46-S50, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32114200

RESUMO

Non-tuberculous mycobacteria (NTM) are ubiquitous dwellers of environmental niches and are an established cause of natural and nosocomial infections. The incidence of NTM infections is rising owing to a growing population of immunocompromised and vulnerable individuals, complex medical and surgical procedures, as well as increased awareness and diagnostic capabilities. The prevalence of different NTM varies between continents, regions, and countries. The true global burden of pulmonary and extrapulmonary disease is unknown and estimates are subject to under and/or over-estimation. Diagnosis requires confirmation by isolation of NTM along with clinical and radiological criteria, which may be suboptimal at all levels. Susceptibility testing is complex and clinical breakpoints are not available for many of the drugs. Frequently, NTM infections are not considered until late in the course of disease. Improved and rapid detection of tuberculosis cases in high-burden countries has, however, also brought NTM infections into the limelight, and has identified a need for research efforts towards rapid diagnostic tests and the identification of biomarkers to monitor the treatment response in patients with NTM infections.


Assuntos
Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Biomarcadores , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/tratamento farmacológico , Doenças Transmissíveis Emergentes/microbiologia , Humanos , Incidência , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Prevalência
3.
Medicine (Baltimore) ; 99(10): e19355, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150075

RESUMO

A remarkable increase in the prevalence of cutaneous nontuberculous mycobacterial (NTM) infection has occurred worldwide. However, updated data regarding cutaneous NTM infection in Thailand is limited.This study aim to describe the clinical manifestations, pathogenic organism, and prognostic factors of cutaneous NTM infections among patients living in Thailand.The electronic medical records of all patients with confirmatory diagnosis of cutaneous NTM infection from either positive cultures or polymerase chain reaction were retrospectively reviewed at a university-based hospital.From 2011 to 2017, a total of 88 patients with a confirmed diagnosis of cutaneous NTM infection were included. Mycobacterium abscessus was the most common pathogens followed by M haemophilum and M marinum (61.4%, 10.2%, and 8.1%, respectively). Nodule and plaque were 2 most common lesions (26.4% and 25.5%, respectively) and lower leg is the most common site of involvement (50.9%). The majority of patients presented with single lesion (67%). Seven patients (7.9%) had history of surgical procedure and/or cosmetic injection before the development of lesion and all pathogenic organisms in this group were rapidly growing mycobacteria. Sweet's syndrome and erythema nodosum were the 2 most common reactive dermatoses, presented in 3.4% and 2.3%, respectively. The majority of patients infected with cutaneous M haemophilum infections were immunocompromised and lacked history of preceding trauma (77.8%). Patients with cutaneous NTM that receiving less than 3 medications was associated with higher disease relapse (odds ratio 65.86; P = .02).M abscessus is the most common pathogen of cutaneous NTM infection in Thailand. The prevalence of M haemophilum is increasing and should be particularly cautious in immunocompromised patients. Rapidly growing mycobacteria should be suspected in all cases of procedure-related cutaneous NTM. We recommend at least 3 antibiotics should be considered for cutaneous NTM infection to reduce the rate of relapse.


Assuntos
Infecções por Mycobacterium não Tuberculosas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas/efeitos dos fármacos , Micobactérias não Tuberculosas/patogenicidade , Razão de Chances , Prevalência , Estudos Retrospectivos , Tailândia/epidemiologia
5.
Int J Infect Dis ; 93: 208-210, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32105768

RESUMO

Talaromyces (formerly Penicillium) marneffei, a dimorphic fungus, is the most common opportunistic pathogen in human immunodeficiency viruses (HIV)-positive patients, but it rarely appears in HIV-negative individuals. Previously, in 2014, we reported the case of an HIV-negative Chinese woman with disseminated T. marneffei infection within an osteolytic lesion. Subsequently, she was followed up for 6 years, and we present an updated report of her clinical condition during the follow-up period. She presented with T. marneffei infection relapse and nontuberculous mycobacterium (NTM) infection. Laboratory tests showed anti-interferon-gamma (anti-IFN-γ) autoantibody-positive. Antifungals and anti-NTM treatment successfully improved her symptoms and laboratory results. This case highlights the type of infectious diseases that occurs as a result of immunodeficiency syndrome associated with anti-IFN-γ autoantibody.


Assuntos
Coinfecção/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Micoses/diagnóstico , Talaromyces , Antifúngicos/uso terapêutico , Autoanticorpos , Feminino , Seguimentos , Humanos , Interferon gama/imunologia , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/imunologia , Micoses/complicações , Micoses/tratamento farmacológico , Micoses/imunologia , Osteólise , Recidiva
6.
Int J Infect Dis ; 92: 226-227, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31978582

RESUMO

We describe a case of persistent tenosynovitis in the right fourth finger of a 50-year-old man that after almost a year of workup was found to be related to osteomyelitis caused by Mycobacterium arupense. The few cases found in the literature were associated with traumatic injuries, environmental contamination, and months of misdiagnosis. Treatment is challenging as there are limited data available on antimicrobial susceptibility and potential side effects of current therapy options.


Assuntos
Infecções por Mycobacterium não Tuberculosas/diagnóstico , Micobactérias não Tuberculosas/isolamento & purificação , Osteomielite/diagnóstico , Traumatismos dos Dedos/complicações , Traumatismos dos Dedos/microbiologia , Traumatismos dos Dedos/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia , Osteomielite/microbiologia , Osteomielite/patologia , Tenossinovite/diagnóstico , Tenossinovite/microbiologia , Tenossinovite/patologia
8.
Ann Otol Rhinol Laryngol ; 129(1): 82-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31522522

RESUMO

OBJECTIVE: The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]). METHOD: Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms. RESULTS: Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF. CONCLUSION: Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.


Assuntos
Blastomicose/diagnóstico , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Tuberculose Laríngea/diagnóstico , Adulto , Biópsia , Blastomyces , Blastomicose/complicações , Blastomicose/patologia , Tosse/etiologia , Técnicas de Cultura , Diagnóstico Diferencial , Feminino , Rouquidão/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium fortuitum , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/patologia , Tuberculose Laríngea/complicações , Tuberculose Laríngea/patologia
9.
Ann Lab Med ; 40(2): 169-173, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31650734

RESUMO

The GENEDIA MTB/NTM Detection Kit (GENEDIA MTB/NTM; Green Cross Medical Science Corp., Chungbuk, Korea) is a multiplex real-time PCR assay used for differential identification of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM). While the importance of differential identification of MTB/NTM is recognized, there is limited data on the performance of GENEDIA MTB/NTM assay to date. A total of 687 consecutive sputum specimens were cultured and analyzed with the GENEDIA MTB/NTM and GENEDIA MTB assays. Nineteen specimens (2.8%) were MTBC-positive, and 69 (10.0%) were NTM-positive based on mycobacterial culture. All specimens showed concordant results for MTBC using both assays, with a kappa value of 1.00, overall sensitivity of 63.2% (12/19), and specificity of 100% (668/668). The overall NTM sensitivity and specificity were 23.2% (16/69) and 99.7% (616/618) for GENEDIA MTB/NTM. The association between NTM-positivity using GENEDIA MTB/NTM and the diagnosis of NTM pulmonary disease was not statistically significant. In conclusion, the two real-time PCR assays showed similar diagnostic performance for MTBC detection. However, the sensitivity for NTM detection was lower than that for MTBC detection.


Assuntos
Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium tuberculosis/genética , Micobactérias não Tuberculosas/genética , Escarro/microbiologia , Tuberculose/diagnóstico , DNA Bacteriano/análise , Humanos , Reação em Cadeia da Polimerase Multiplex , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Micobactérias não Tuberculosas/isolamento & purificação , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade , Tuberculose/microbiologia
12.
Dermatol Surg ; 46(1): 116-121, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30964788

RESUMO

BACKGROUND: Nontuberculous mycobacterium (NTM) infection following cosmetic procedures usually results from inadequate sterile techniques and contamination from nonsterile water. These infections are difficult to diagnose and treat. OBJECTIVE: This study aimed to describe the characteristics of NTM infections acquired after an aesthetic procedure, identify high-risk patients and high-risk cosmetic procedures, and provide a diagnostic and management algorithm for NTM infections occurring after cosmetic procedures. METHODS: On December 20, 2017 an online search of the Medline database was done. All articles describing NTM infection in cosmetic procedures were included in this review. RESULTS: In total, 92 patients with a mean age of 38.35 years were included in this review. Cosmetic procedures performed in the Dominican Republic were the most common source of infection and were noted in 33 patients. The procedure that resulted in the highest proportion of the infections was mesotherapy (34%). In most of the cases, the diagnosis was missed at the initial presentation and a short course of inadequate antibiotics was unsuccessful. CONCLUSION: Nontuberculous mycobacterium infections are hard to diagnose and difficult to treat, sometimes leading to severe irreversible sequalae. Aesthetic practitioners should know when to suspect and how to prevent, diagnose, and treat NTM infections.


Assuntos
Algoritmos , Técnicas Cosméticas/efeitos adversos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/terapia , Humanos , Infecções por Mycobacterium não Tuberculosas/etiologia
13.
Indian J Tuberc ; 66(4): 461-467, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31813432

RESUMO

INTRODUCTION: With the introduction of newer molecular diagnostic tools, an increasing number of Non-tuberculous Mycobacteria (NTM) affecting the respiratory system and mimicking symptoms of pulmonary tuberculosis (PTB) are being identified. They may be misdiagnosed and treated as PTB, often categorized as treatment failures if they do not respond to treatment. This manuscript aims to characterize patients with pulmonary NTM disease. METHODS: Patient characteristics of bacteriologically confirmed pulmonary NTM disease, attending the ICMR-National Institute for Research in Tuberculosis, Chennai were prospectively compiled over a two-year period (2017-2018). RESULTS: A total of 122 patients with recurrent chest symptoms and not responding to anti-tuberculosis treatment were screened for NTM. Thirty-nine cases (26 males and 13 females) of symptomatic pulmonary NTM were diagnosed. The mean (SD) patient age and body mass index were 48.6 ± 11 years and 16.3 ± 3. All male participants were smokers, had at least one episode of previous ATT. Mycobacterium kansasii (48.7%) was the most frequently isolated species followed by Mycobacterium intracellulare (20.5%), Mycobacterium abscessus (7.6%) followed by Mycobacterium avium, Mycobacterium fortuitum, Mycobacterium kyorinense, and Mycobacterium simiae. Infection with multiple NTMs was seen in four patients. Isoniazid resistance was identified in 20 patients. Based on species identified, treatment was initiated as per American Thoracic Society guidelines and continued up to 12 months of culture negativity. CONCLUSIONS: M. kansasii is the commonest pulmonary NTM isolated in Tamilnadu with a higher prevalence in males and elderly. Sensitization of both patients and providers is essential to avoid misdiagnosis and delay in diagnosis of pulmonary NTM disease as pulmonary TB.


Assuntos
Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas/isolamento & purificação , Adulto , Idoso , Antituberculosos/farmacologia , Estudos de Coortes , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas/efeitos dos fármacos , Prevalência , Estudos Prospectivos , Escarro/microbiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia , Adulto Jovem
14.
BMJ Case Rep ; 12(12)2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31818890

RESUMO

We present a case of a 28-year-old woman who came to medical attention after noticing a breast mass associated with an overlying eroded plaque of the skin. A core biopsy of the breast mass was negative for malignancy but demonstrated granulomatous inflammatory changes. Acid-fast bacilli and Gomori methenamine-silver stains were negative for microorganisms. The patient was diagnosed with presumptive idiopathic granulomatous mastitis and started on oral steroids. Her symptoms progressed. Tissue culture from a repeat biopsy grew Mycobacterium mucogenicum The patient responded well to combination oral antimicrobial therapy.


Assuntos
Mastite Granulomatosa/diagnóstico , Mycobacteriaceae , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Dermatopatias Bacterianas/microbiologia , Infecções dos Tecidos Moles/microbiologia , Adulto , Claritromicina/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/tratamento farmacológico , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
15.
BMJ Case Rep ; 12(12)2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31818891

RESUMO

Mycobacterium c helonae is one of the rapidly growing non-tuberculous mycobacteria that can be isolated from water, soils and aerosols. Localised infections have been reported associated with tattoo parlours, pedicures and cosmetic procedures. But disseminated infection is usually associated with individuals who are immunocompromised, predominantly affecting limbs but sparing abdomen and back. We herein present a case where patient was on immunosuppressive therapy and developed locally severe infection around right ankle. A 69-year-old woman known to rheumatology presents in outpatients with severe pain in right ankle, unable to bear weight, oedematous right foot and lower leg. There was extensive erythematous cellulitic skin rash around right ankle and lower leg. She had background history of systemic lupus erythematosus with previous history of cardiac myositis and left foot drop. She had six cycles of cyclophosphamide for flare of lupus and after last cycle developed this presentation. Skin biopsy was arranged with dermatologist, cultures from which grew M . chelonae She was admitted and started on triple regimen for M . chelonae as per Microbiology guidelines with intention to complete 6-12 months treatment. Patient responded very well to treatment but unfortunately, she died after 5 months on treatment due to other comorbidities and likely cause of death was cardiac arrhythmia.


Assuntos
Hospedeiro Imunocomprometido , Lúpus Eritematoso Sistêmico/imunologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium chelonae , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/microbiologia , Idoso , Antibacterianos/uso terapêutico , Claritromicina/uso terapêutico , Ciclofosfamida/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Imipenem/uso terapêutico , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Dermatopatias Bacterianas/complicações , Dermatopatias Bacterianas/tratamento farmacológico , Tobramicina/uso terapêutico , Resultado do Tratamento
16.
Int J Mycobacteriol ; 8(4): 400-402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31793513

RESUMO

Mycobacterium fortuitum is ubiquitous in nature and can cause a wide variety of lesions in humans with immunocompromised or antecedent chronic illness. Clinical diagnosis is difficult and relapses are seen. This is due to the fact that they are not critically investigated and are not responded to traditional antitubercular treatment and other antibiotics. Herewith, we report a case of M. fortuitum causing laparotomy port infection-causing repeated multiple abscess on the anterior abdominal wall and treated with amikacin and clarithromycin. The wound healed completely and the patient recovered after administering a combination of amikacin and clarithromycin. We conclude that strict standard operating procedures should be followed to prevent mycobacteria other than tuberculosis (MOTT) infections during and after surgical procedures. Any postoperative, chronic infection which is not responding to conventional antibiotics should be highly suspected for such MOTT infections. Antibiotic susceptibility testing should be performed so as to identify the required antibiotic combination and treated accordingly to prevent further complications and to reduce the cost of treatment.


Assuntos
Abdome/cirurgia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium fortuitum/isolamento & purificação , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/microbiologia , Abdome/microbiologia , Adulto , Antituberculosos/uso terapêutico , Apendicite/cirurgia , Gerenciamento Clínico , Humanos , Laparotomia , Masculino , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium fortuitum/efeitos dos fármacos
17.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(11): 826-831, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31694092

RESUMO

Objectives: Long-term use of inhaled corticosteroids (ICS) was reported as a risk factor for patients with chronic obstructive pulmonary disease (COPD) complicated with nontuberculous mycobacterial lung disease (NTM-LD). But it was not reported often in China. Methods: We conducted a retrospective analysis of patients who were diagnosed with COPD and NTM-LD in our department from January 1(st) 2017 to December 31(th) 2018. Results: This study consisted of 10 male and 5 female patients with a mean age of (66±7) years. The detailed clinical data and radiological images were reviewed systemically. There were 4 current smokers (26.7%) and 6 past smokers (40%). All cases were current ICS users, with a mean duration of (27.3±9.7) months, ranging from 3 months to 61 months. Among them, 8 cases (53.3%) used inhaled fluticasone and 7 cases (46.7%) used inhaled budesonide. Aggravated coughing (15 cases, 100%), expectoration (15 cases, 100%) and dyspnea (10 cases, 66.7%) were the common clinical manifestations, although fever was only reported in 4 cases (26.7%). All cases showed normal white blood cell count and lymphocyte count, and some of them (7 cases, 46.7%) showed elevated erythrocyte sedimentation rate and C-reactive protein. Most of them (14 cases, 93.3%) had normal TB-SPOT results. Multiple focal bronchiectasis (9 cases, 60%) and significant emphysema (12 cases, 80%) were the common manifestations of basic high-resolution CT (HRCT) prior NTM infection. The occurrence of bronchiectasis (15 cases, 100%), "tree in bud" sign (12 cases, 80%) and tiny cavities (8 cases, 53.3%) were the common HRCT abnormalities for the NTM-LD cases. According to the 2007's NTM-LD diagnosis criteria, most of them (13 cases, 86.7%) were diagnosed with positive sputum samples at least twice, and 2 cases were diagnosed with positive CT-directed bronchial alveolar lavage fluid. NTM-PCR analysis was performed routinely for the isolated NTM samples to identify the NTM species. Mycobacterium avium complex (MAC) was the most common NTM species (8 cases, 53.3%). After treatment with proposed anti-NTM strategies, most cases improved (9 cases, 60%), and some of them (4 cases, 26.7%) were cured and a few cases (2 cases, 13.3%) relapsed. Conclusions: When COPD patients treated with ICS showed aggravated cough, expectation and/or dyspnea, and new occurrence of bronchiectasis and/or "tree in bud" sign in the recent HRCT, the differential diagnosis of NTM-LD should be considered. Respiratory samples should be arranged for NTM cultures and PCR analysis as soon as possible. Earlier antimicrobial strategies according to the identified NTM species would improve the clinical outcomes.


Assuntos
Glucocorticoides/administração & dosagem , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Fármacos do Sistema Respiratório/administração & dosagem , Administração por Inalação , Idoso , China/epidemiologia , Feminino , Glucocorticoides/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Sistema Respiratório/microbiologia , Sistema Respiratório/fisiopatologia , Fármacos do Sistema Respiratório/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
18.
Medicine (Baltimore) ; 98(48): e18179, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770270

RESUMO

RATIONALE: Immunoglobulin G4-related disease (IgG4-RD) is regarded as an immune-mediated systemic fibroinflammatory disease. Several studies have linked IgG4-RD to infections such as tuberculosis and actinomycosis. However, the coexistence of IgG4-RD and non-tuberculous mycobacterium (NTM) in a single pulmonary nodule has not been reported yet. PATIENT CONCERNS: A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT. DIAGNOSIS: Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made. INTERVENTIONS: Antibiotic treatment was applied for pneumonia developed after surgery. The patient was also supported by extracorporeal membrane oxygenation and mechanical ventilation since his pneumonia was refractory to medical treatment. OUTCOMES: The patient expired on the 60th postoperative day due to multiple organ failure. LESSONS: IgG4-RD can occur singularly or accompanied by other diseases. We report a solitary pulmonary nodule caused by NTM and concurrent IgG4-RD, suggesting a possible association between these 2 entities. Immunologic relations between IgG4-RD and accompanying infection should be further investigated.


Assuntos
Doença Relacionada a Imunoglobulina G4 , Infecções por Mycobacterium não Tuberculosas , Micobactérias não Tuberculosas/isolamento & purificação , Pneumonia , Complicações Pós-Operatórias/tratamento farmacológico , Nódulo Pulmonar Solitário , Cirurgia Torácica Vídeoassistida/métodos , Idoso , Antibacterianos/administração & dosagem , Biópsia/métodos , Oxigenação por Membrana Extracorpórea/métodos , Evolução Fatal , Humanos , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/patologia , Infecções por Mycobacterium não Tuberculosas/terapia , Pneumonia/tratamento farmacológico , Pneumonia/etiologia , Nódulo Pulmonar Solitário/complicações , Nódulo Pulmonar Solitário/microbiologia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Tomografia Computadorizada por Raios X/métodos
19.
F1000Res ; 82019.
Artigo em Inglês | MEDLINE | ID: mdl-31602293

RESUMO

Nontuberculous mycobacteria (NTM) are members of the Mycobacterium genus other than Mycobacterium tuberculosis complex and Mycobacterium leprae. NTM are widely distributed in the environment and are increasingly recognized as causes of chronic lung disease that can be challenging to treat. In this brief review, we consider recent developments in the ecology, epidemiology, natural history, and treatment of NTM lung disease with a focus on Mycobacterium avium complex (MAC) and Mycobacterium abscessus complex .


Assuntos
Pneumopatias/diagnóstico , Pneumopatias/terapia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/terapia , Humanos , Pneumopatias/microbiologia , Mycobacterium abscessus , Complexo Mycobacterium avium
20.
J Korean Med Sci ; 34(39): e258, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31602828

RESUMO

Para-Bombay phenotypes are rare blood groups that have inherent defects in producing H antigens associated with FUT1 and/or FUT2. We report the first case of para-Bombay blood type in a Southeast Asian patient admitted at a tertiary hospital in Korea. A 23-year-old Indonesian man presented to the hospital with fever and was diagnosed with a disseminated nontuberculous mycobacterium infection and anemia. During blood group typing for blood transfusion, cell typing showed no agglutination with both anti-A and anti-B reagents. Serum typing showed strong reactivity against B cells and trace agglutination pattern with A1 cells. His red blood cells failed to react with anti-H reagents. Direct sequencing of FUT1 and FUT2 revealed a missense variation, c.328G>A (p.Ala110Thr, rs56342683, FUT1*01W.02), and a synonymous variant, c.390C>T (p.Asn130=, rs281377, Se357), respectively. This highlights the need for both forward and reverse grouping.


Assuntos
Sistema ABO de Grupos Sanguíneos/genética , Fucosiltransferases/genética , Grupo com Ancestrais do Continente Asiático/genética , Transfusão de Sangue , Humanos , Indonésia , Masculino , Mutação de Sentido Incorreto , Infecções por Mycobacterium não Tuberculosas/diagnóstico , República da Coreia , Análise de Sequência de DNA , Centros de Atenção Terciária , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA